Mamun Mohammed A, Safiq Mariam Binte, Hosen Ismail, Al Mamun Firoj
Centre for Health Innovation, Networking, Training, Action and Research - Bangladesh (CHINTA Research Bangladesh), Dhaka, Bangladesh.
Department of Public Health and Informatics, Jahangirnagar University, Savar, Dhaka, Bangladesh.
Risk Manag Healthc Policy. 2021 Jan 13;14:129-142. doi: 10.2147/RMHP.S282965. eCollection 2021.
Bangladeshi flood survivors are reported with such higher mental disorders that are not ever observed in any other cohorts. Although there are a few studies that assessed mental disorders, suicide or suicidal behaviors are not investigated yet. Hence, the present study for the first time investigated suicidal behaviors and its relationship with socio-demographics, flood effects and psychopathology.
A cross-sectional interview study was carried out between November and December 2019, after 4/5 months of the flood occurrence. Two completely affected villages from two districts residing in two parts of the country were randomly selected (whereas Manikganj district was less affected by the recent flood compared to Kurigram), and a total of 348 flood survivors were interviewed (45.53 ± 14.85 years). Questions related to basic socio-demographics, flood effects, psychological impacts, and suicidal behaviors were asked in the interviews.
In the total sample, 57.5% of flood survivors reported having suicidal ideation, whereas 5.7% and 2.0% madea suicide plan and suicide attempt, respectively. Within two study sites, participants belonging to Kurigram reported significantly higher suicidal ideation compared to Manikganj (84.8% vs 33.2%, = 94.475, <0.001). Belonging to a lower-class family, having less education, and less earning members in the family, being affected severely by the flood, suffering from depression, anxiety, and PTSD, and experiencing financial threat, and economic hardship were suicidal behavior risk factors in the total sample.
Considering the present findings (ie, suicidality commensurately increases with flood effects), a multi-sectoral policy and its effective implementation should be adopted for alleviating the flood-related psychological burdens.
据报道，孟加拉国洪水幸存者患有较高的精神障碍，这在其他任何队列中都未曾观察到。尽管有一些研究评估了精神障碍，但尚未对自杀或自杀行为进行调查。因此，本研究首次调查了自杀行为及其与社会人口统计学、洪水影响和精神病理学的关系。
在洪水发生4/5个月后的2019年11月至12月进行了一项横断面访谈研究。从该国两个地区的两个完全受灾村庄中随机选取（与库里格兰相比，马尼干杰地区最近受洪水影响较小），共采访了348名洪水幸存者（年龄45.53±14.85岁）。访谈中询问了与基本社会人口统计学、洪水影响、心理影响和自杀行为相关的问题。
在总样本中，57.5%的洪水幸存者报告有自杀意念，而分别有5.7%和2.0%的人制定了自杀计划和尝试过自杀。在两个研究地点中，库里格兰的参与者报告的自杀意念明显高于马尼干杰（84.8%对33.2%， = 94.475，<0.001）。在总样本中，来自下层阶级家庭、受教育程度较低、家庭收入成员较少、受洪水严重影响、患有抑郁症、焦虑症和创伤后应激障碍、经历经济威胁和经济困难是自杀行为的风险因素。
考虑到目前的研究结果（即自杀倾向随洪水影响相应增加），应采取多部门政策并有效实施，以减轻与洪水相关的心理负担。
